MedNexus
2023年 · 第136卷第11期
出版日期 2023-06-05电子版 ￥0.00元
MedNexus
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- Review Article
- Meta Analysis
- Original Article
- Clinical Observation
- Rapid Report
- Correspondence
Review Article
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肠道微生物群：对神经系统疾病的新认识Lanxiang Liu, Haiyang Wang, Xueyi Chen, Peng Xie
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002212
摘要
In the last decade, it has become increasingly recognized that a balanced gut microbiota plays an important role in maintaining the health of the host. Numerous clinical and preclinical studies have shown that changes in gut microbiota composition are associated with a variety of neurological diseases, e.g., Parkinson’s disease, Alzheimer’s disease, and myasthenia gravis. However, the underlying molecular mechanisms are complex and remain unclear. Behavioral phenotypes can be transmitted from humans to animals through gut microbiota transplantation, indicating that the gut microbiota may be an important regulator of neurological diseases. However, further research is required to determine whether animal-based findings can be extended to humans and to elucidate the relevant potential mechanisms by which the gut microbiota regulates neurological diseases. Such investigations may aid in the development of new microbiota-based strategies for diagnosis and treatment and improve the clinical management of neurological disorders. In this review, we describe the dysbiosis of gut microbiota and the corresponding mechanisms in common neurological diseases, and discuss the potential roles that the intestinal microbiome may play in the diagnosis and treatment of neurological disorders.
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特发性肺纤维化诊断和疾病评估的潜在生物标志物Qing Wang, Zhaoliang Xie, Nansheng Wan, Lei Yang, Zhixian Jin, Fang Jin, Zhaoming Huang, Min Chen, Huiming Wang, Jing Feng
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002171
摘要
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia. IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration; thus, a differential diagnosis remains challenging. Several biomarkers have been identified to achieve a differential diagnosis; however, comprehensive reviews are lacking. This review summarizes over 100 biomarkers which can be divided into six categories according to their functions: differentially expressed biomarkers in the IPF compared to healthy controls; biomarkers distinguishing IPF from other types of interstitial lung disease; biomarkers differentiating acute exacerbation of IPF from stable disease; biomarkers predicting disease progression; biomarkers related to disease severity; and biomarkers related to treatment. Specimen used for the diagnosis of IPF included serum, bronchoalveolar lavage fluid, lung tissue, and sputum. IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF. Currently, the physiological measurements used to evaluate the occurrence of acute exacerbation, disease progression, and disease severity have limitations. Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF. Most biomarkers described in this review are not routinely used in clinical practice. Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.
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骨髓细胞表达的触发受体2-载脂蛋白E信号通路与疾病的关系Shukai Lyu, Zhuoqing Lan, Caixia Li
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002167
摘要
Triggering receptor expressed on myeloid cells 2 (TREM2) is a membrane receptor on myeloid cells and plays an important role in the body’s immune defense. Recently, TREM2 has received extensive attention from researchers, and its activity has been found in Alzheimer’s disease, neuroinflammation, and traumatic brain injury. The appearance of TREM2 is usually accompanied by changes in apolipoprotein E (ApoE), and there has been a lot of research into their structure, as well as the interaction mode and signal pathways involved in them. As two molecules with broad and important roles in the human body, understanding their correlation may provide therapeutic targets for certain diseases. In this article, we reviewed several diseases in which TREM2 and ApoE are synergistically involved in the development. We further discussed the positive or negative effects of the TREM2-ApoE pathway on nervous system immunity and inflammation.
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miRNA、lncRNA和circRNA在妊娠相关疾病中的新作用Xiaoxiao Fu, Yuling Li, Zhen Zhang, Bin Wang, Ran Wei, Chu Chu, Ke Xu, Lihua Li, Yonglin Liu, Xia Li
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002595
摘要
Accumulating studies have demonstrated that non-coding RNAs (ncRNAs), functioning as important regulators of transcription and translation, are involved in the establishment and maintenance of pregnancy, especially the maternal immune adaptation process. The endometrial stromal cells (ESCs), trophoblast cells, and decidua immune cells that reside at the maternal-fetal interface are thought to play significant roles in normal pregnancy and pregnancy-associated diseases. Here, we reviewed the up-to-date evidence on how microRNA, long non-coding RNA, and circular RNA regulate ESCs, trophoblast cells, and immune cells and discussed the potential applications of these ncRNAs as diagnostic and therapeutic markers in pregnancy complications.
Meta Analysis
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糖尿病视网膜病变患者丙二醛水平的系统评价和荟萃分析Fanwen Jiang, Lin Zhou, Chun Zhang, Hui Jiang, Zhuping Xu
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002620
摘要
Background:
It remains unclear whether circulating malondialdehyde (MDA) levels change in people with diabetic retinopathy (DR). This systematic review compared circulating MDA levels in diabetic people with and without DR.
Methods:
PubMed, Medline (Ovid), Embase (Ovid), and Web of Science were searched for case-control studies conducted before May 2022 in English that compared circulating MDA levels in people with and without DR. The following MeSH search terms were used: ( "malondialdehyde" or "thiobarbituric acid reactive substances [TBARS]" or "lipid peroxidation" or "oxidative stress" ) and "diabetic retinopathy." Newcastle-Ottawa Quality Assessment Scale was used to evaluate the quality of the included studies. Random-effects pairwise meta-analysis pooled the effect size with standardized mean difference (SMD) and 95% confidence intervals (CIs).
Results:
This meta-analysis included 29 case-control studies with 1680 people with DR and 1799 people with diabetes but not DR. Compared to people without DR, the circulating MDA levels were higher in those with DR (SMD, 0.897; 95% CI, 0.631 to 1.162; P < 0.001). The study did not identify credible subgroup effects or publication bias and the sensitivity analysis confirmed the robustness of the study.
Conclusions:
Circulating MDA levels are higher in people with DR compared to those without. Future comparative studies that use more specific methods are required to draw firm conclusions.
Registration:
PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; No. CRD42022352640.
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不同肝细胞癌筛查间隔或方式的比较有效性：一项系统综述和荟萃分析Jichun Yang, Zhirong Yang, Xueyang Zeng, Shuqing Yu, Le Gao, Yu Jiang, Feng Sun
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002341
摘要
Background:
Current guidelines recommend hepatocellular carcinoma (HCC) screening in high-risk populations. However, the ideal HCC screening interval and screening modality have not been determined. This study aimed to compare the screening efficacy among different modalities with various intervals.
Methods:
PubMed and other nine databases were searched through June 30, 2021. Binary outcomes were pooled using risk ratio (RR) with 95% confidence intervals (CIs). Survival rates were also pooled using RR with 95% CIs because most eligible studies only provided the number of survival patients instead of hazard ratio.
Results:
In all, 13 studies were included. Two random controlled trials (RCTs) and six cohort studies compared screening intervals for ultrasonography (US) screening and found no significant differences between shorter (3- or 4-month) and longer (6- or 12-month) screening intervals in terms of early HCC proportion, HCC significant mortality, 1-year survival rate; screening at 6-month interval significantly increased the proportion of early HCC (RR = 1.17, 95% confidence interval [CI]: 1.08-1.26) and prolonged the 5-year survival rate (RR = 1.39, 95% CI: 1.07-1.82) relative to the 12-month interval results. Three other RCTs and two cohort studies compared different screening modalities in cirrhosis or chronic hepatitis B, which indicated no statistical differences in the proportion of early HCC (RR = 0.89, 95% CI: 0.40-1.96) and HCC mortality (RR = 0.69, 95% CI: 0.23-2.09) between the biannual US and annual computed tomography (CT screening). Biannual US screening showed a lower proportion of early HCC than biannual magnetic resonance imaging (MRI) (RR = 0.60, 95% CI: 0.37-0.97) and biannual US combined with annual CT (RR = 1.31, 95% CI: 1.13-1.51) screening. The proportion of early HCC in the contrast-enhanced US group was slightly higher than that in the B-mode US (RR= 1.08, 95% CI: 1.00-1.23) group.
Conclusions:
The evidence suggests that 6 months may be the best HCC screening interval for US screening. The effectiveness of CT and MRI is better than US during same screening intervals. However, MRI and CT are more expensive than US, and CT also can increase the risk of radiation exposure. The selection of CT or MRI instead of US should be carefully considered.
Registration:
No. CRD42020148258 at PROSPERO website (https://www.crd.york.ac.uk/PROSPERO/).
Original Article
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无合并症的药物初治惊恐障碍患者杏仁核亚区功能连接增加Ping Zhang, Xiangyun Yang, Yun Wang, Huan Liu, Limin Meng, Zijun Yan, Yuan Zhou, Zhanjiang Li
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002439
摘要
Background:
Amygdala plays an important role in the neurobiological basis of panic disorder (PD), and the amygdala contains different subregions, which may play different roles in PD. The aim of the present study was to examine whether there are common or distinct patterns of functional connectivity of the amygdala subregions in PD using resting-state functional magnetic resonance imaging and to explore the relationship between the abnormal spontaneous functional connectivity patterns of the regions of interest (ROIs) and the clinical symptoms of PD patients.
Methods:
Fifty-three drug-naïve, non-comorbid PD patients and 70 healthy controls (HCs) were recruited. Seed-based resting-state functional connectivity (rsFC) analyses were conducted using the bilateral amygdalae and its subregions as the ROI seed. Two samples t test was performed for the seed-based Fisher's z-transformed correlation maps. The relationship between the abnormal spontaneous functional connectivity patterns of the ROIs and the clinical symptoms of PD patients was investigated by Pearson correlation analysis.
Results:
PD patients showed increased rsFC of the bilateral amygdalae and almost all the amygdala subregions with the precuneus/posterior cingulate gyrus compared with the HC group (left amygdala [lAMY]: t = 4.84, P <0.001; right amygdala [rAMY]: t= 4.55, P <0.001; left centromedial amygdala [lCMA]: t= 3.87, P <0.001; right centromedial amygdala [rCMA]: t= 3.82, P= 0.002; left laterobasal amygdala [lBLA]: t= 4.33, P <0.001; right laterobasal amygdala [rBLA]: t= 4.97, P <0.001; left superficial amygdala [lSFA]: t= 3.26, P = 0.006). The rsFC of the lBLA with the left angular gyrus/inferior parietal lobule remarkably increased in the PD group (t = 3.70, P = 0.003). And most of the altered rsFCs were located in the default mode network (DMN). A significant positive correlation was observed between the severity of anxiety and the rsFC between the lSFA and the left precuneus in PD patients (r = 0.285, P = 0.039).
Conclusions:
Our research suggested that the increased rsFC of amygdala subregions with DMN plays an important role in the pathogenesis of PD. Future studies may further explore whether the rsFC of amygdala subregions, especially with the regions in DMN, can be used as a biological marker of PD.
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三重体重指数评估中国3~17岁儿童青少年心脏代谢危险因素的准确性和能力与体重指数的比较Rui Chen, Lang Ji, Lijuan Ma, Yitong Chen, Jiali Duan, Mingjing Ma, Ying Sun, Jun Tai, Linghui Meng
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002349
摘要
Background:
Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children.
Methods:
A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI-z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate.
Results:
Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m3 for boys and 13.3 ± 2.33 kg/m3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI-z scores standardized according to World Health Organization criteria.
Conclusions:
TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.
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下调心脏PIASy抑制Cx43 SUMO化改善心肌缺血/再灌注损伤大鼠室性心律失常Tingting Wang, Jinmin Liu, Chenchen Hu, Xin Wei, Linlin Han, Afang Zhu, Rong Wang, Zhijun Chen, Zhengyuan Xia, Shanglong Yao 等
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002618
摘要
Background:
Dysfunction of the gap junction channel protein connexin 43 (Cx43) contributes to myocardial ischemia/reperfusion (I/R)-induced ventricular arrhythmias. Cx43 can be regulated by small ubiquitin-like modifier (SUMO) modification. Protein inhibitor of activated STAT Y (PIASy) is an E3 SUMO ligase for its target proteins. However, whether Cx43 is a target protein of PIASy and whether Cx43 SUMOylation plays a role in I/R-induced arrhythmias are largely unknown.
Methods:
Male Sprague-Dawley rats were infected with PIASy short hairpin ribonucleic acid (shRNA) using recombinant adeno-associated virus subtype 9 (rAAV9). Two weeks later, the rats were subjected to 45 min of left coronary artery occlusion followed by 2 h reperfusion. Electrocardiogram was recorded to assess arrhythmias. Rat ventricular tissues were collected for molecular biological measurements.
Results:
Following 45 min of ischemia, QRS duration and QTc intervals statistically significantly increased, but these values decreased after transfecting PIASy shRNA. PIASy downregulation ameliorated ventricular arrhythmias induced by myocardial I/R, as evidenced by the decreased incidence of ventricular tachycardia and ventricular fibrillation, and reduced arrythmia score. In addition, myocardial I/R statistically significantly induced PIASy expression and Cx43 SUMOylation, accompanied by reduced Cx43 phosphorylation and plakophilin 2 (PKP2) expression. Moreover, PIASy downregulation remarkably reduced Cx43 SUMOylation, accompanied by increased Cx43 phosphorylation and PKP2 expression after I/R.
Conclusion:
PIASy downregulation inhibited Cx43 SUMOylation and increased PKP2 expression, thereby improving ventricular arrhythmias in ischemic/reperfused rats heart.
Clinical Observation
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evolocumab在中国极高风险心血管患者中的降脂作用和安全性：一项单中心研究Meng Chai, Haitao Zhang, Lixia Yang, Jing Liang, Hongya Han, Xiaoli Liu, Xiaoteng Ma, Yan Liu, Dongmei Shi, Yingxin Zhao 等
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002399
摘要
低密度脂蛋白胆固醇（LDL-C）是动脉粥样硬化性心血管疾病（ASCVD）的独立危险因素。即使在使用他汀类药物或他汀类药物-依折麦布进行降脂治疗（LLT）后，仍有很大比例的极高风险患者仍未达到LDL-C目标（<1.4 mmol/L且降低≥50%）。[
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成人病毒性肺炎合并侵袭性肺曲霉病的临床特点及危险因素分析Lijuan Li, Chuan Wang, Yali Ren, Jiangbo Liu, Feifei Liu, Xiaoqi Zhang
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002354
摘要
病毒性肺炎最近被定义为侵袭性肺曲霉病（IPA）的危险因素。沃特斯等人[
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年轻冠心病患者再住院心血管危险因素控制与急性心肌梗死的关系Hongxia Yang, Huijuan Zuo, Xiaofan Wu, Shujie Jia, Xiantao Song
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002173
摘要
冠心病（CHD）危险因素的增加可以解释年轻CHD患者负担逐渐增加的原因。可改变的危险因素与急性心肌梗死（AMI）之间的关联已得到很好的确立，控制心血管危险因素可以降低后续事件的风险。[
Rapid Report
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葡萄球菌盒式染色体的特征哥们和lugdunin操纵子基因卢格敦葡萄球菌Shining Fu, Yusheng Chen, Ke Hu, Tian Qin, Yukun He, Lili Zhao, Xinqian Ma, Li Chen, Wenyi Yu, Yan Yu 等
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002430
摘要
卢格敦葡萄球菌(卢格敦链球菌）是凝固酶阴性葡萄球菌包括正常皮肤微生物群，主要定居在下腹部和四肢。[
Correspondence
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化疗诱导恶心呕吐预测模型的真实世界验证及其识别中国高危患者的优化Linlin Zhang, Lili Zeng, Yinjuan Sun, Jing Wang, Cong Wang, Chang Liu, Ming Ding, Manman Quan, Zhanyu Pan, Diansheng Zhong
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002265
摘要
致编辑：化疗引起的恶心和呕吐（CINV）是接受化疗的患者报告的最常见和最害怕的副作用。尽管取得了重大进展，但CINV的发病率仍然很高。[
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2019年冠状病毒病和稳定型心绞痛患者心绞痛发作的血液危险因素Song Geng, Donghui Zhou, Qi Wang, Guofeng Wang, Wei Wei, Tao Yu, Zhiying Duan, Jing Liu, Fei Yu, Yuanzhe Jin
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002334
摘要
致编辑：冠心病（CHD）并发冠状病毒疾病2019（新冠肺炎）的患者发生冠状动脉事件的风险增加。许多研究报告了心血管疾病和新冠肺炎之间的联系。众所周知，如果新冠肺炎患者患有心血管疾病，他们的预后更差，死亡风险更高。[
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微创方法会影响全膝关节置换术的长期临床结果吗？至少随访10年的队列分析Fuzhen Yuan, Zewen Sun, Jiangnan Fu, Meng Yang, Jiying Zhang, Yourong Chen, Jiakuo Yu
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002125
摘要
致编辑：全膝关节置换术（TKA）是终末期膝关节骨关节炎患者安全有效的治疗方法，采用传统的内侧髌旁（MP）入路进行TKA，可以获得良好的膝关节可视化，有助于实现正确的截骨、适当的韧带平衡和良好的假体位置，这些都是良好的长期结果的重要因素。[
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颞骨高分辨率计算机断层扫描对内听道周围气室分布和体积的评估Xinping Hao, Yitao Liu, Ying Shi, Biao Chen, Bentao Yang, Yunfu Liu, Yongxin Li
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002451
摘要
致编辑：听神经瘤是桥小脑角（CPA）区最常见的肿瘤。听神经瘤的手术入路包括迷路、中颅窝、乙状窦后入路和迷路后入路。然而，无论采用何种方法暴露内听道（IAC）中的肿瘤，都必须擦伤IAC周围的骨，这不可避免地暴露周围的气室受到损伤，并增加了术后脑脊液（CSF）泄漏的风险。脑脊液漏是从CPA区域切除肿瘤后最常见的术后并发症，据报道，听神经瘤手术后的发生率为2%至10%。[
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改善的结果E2A：：HLF嵌合抗原受体T细胞联合BCL-2抑制剂治疗B细胞阳性急性淋巴细胞白血病Shumin Chen, Ye Li, Zheng Wang, Lin Feng, Yueping Jia, Xiaodong Mo, Yu Wang, Qian Jiang, Xiaojun Huang, Yueyun Lai
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002481
摘要
致编辑：融合基因E2A：：HLF(TCF3：：HLF）由t（17；19）（q21-22；p13）形成，其存在于<1%的B细胞急性淋巴细胞白血病（B-ALL），主要发生于年龄较大的儿童和青少年。[
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一例接受嵌合抗原受体-T细胞治疗的患者中由程序性细胞死亡蛋白1抑制剂引起的中毒性表皮坏死Chengji Wang, Na Yao, Liqiang Wei, Aihua Wei, Liang Wang
中华医学杂志英文版2023年 136卷 11期
DOI: 10.1097/CM9.0000000000002579
摘要
致编辑：中毒性表皮坏死（TEN）是一种严重的皮肤粘膜反应，以皮疹、水泡和表皮全身松弛为特征。[
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